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Hydration status in older adult patients and the relationship to factors affecting the access and intake of fluid : a thesis presented in partial fulfillment of the requirements for the degree of Masters of Science in Nutrition and Dietetics at Massey University
Objectives:
To
assess
fluid
intake
and
access
among
hospitalised
patients
≥65
or
≥55
years
and
to
compare
total
fluid
intake
with
the
patient’s
hydration
status
as
determined
by
serum
osmolality.
Methods:
Eligible
patients,
aged
were
recruited
from
Northshore
and
Waitakere
hospitals
within
the
Waitemata
DHB
in
NZ.
Socio-‐demographic
characteristics
were
collected
using
an
electronic
questionnaire.
The
patients’
fluid
intake
was
measured
using
the
interactive
FIAT,
which
enabled
patients
to
select
any
beverage
or
high
fluid
food
(e.g.
jelly,
custard,
soup)
that
they
had
consumed
from
the
hospital,
onsite
cafeteria,
and
vending
machines.
The
patients
were
able
to
indicate
how
much
they
had
consumed
using
a
visual
representation
of
the
product
filled
at
various
volumes
for
guidance.
The
patients’
access
to
fluid
and
potential
barriers
to
them
meeting
their
fluid
requirements
was
assessed
using
the
FAST
on
an
electronic
device.
Serum
osmolality,
sodium,
potassium,
haematocrit
and
creatinine
were
determined
as
indicators
of
hydration
status
and
collected
within
24
hours
of
the
FIAT
and
FAST.
Results:
The
study
sample
(n=54)
included
23
(43%)
men
and
31
(57%
women)
with
a
mean
age
of
82.5±8.10
years.
The
FIAT
identified
that
the
majority
of
patients
did
not
meet
their
fluid
recommendations
(n=46,
90%)
and
that
half
(n=27)
had
a
low
fluid
intake
of
less
than
1.6L/day.
The
FAST
identified
that
of
those
patients
with
low
fluid
intake
16
(59%)
struggled
to
open
fluid
containers
and
10
(37%)
sought
assistance
with
opening.
Patients
who
struggled
to
open
fluids
had
a
higher
mean
serum
osmolality
than
those
who
didn’t
struggle
(297±6.88mOsm/kg
versus
291±7.80mOsm/kg,
P=0.009).
Half
of
the
patients
were
impending
dehydration
(n=15,
33%)
or
were
dehydrated
(n=9,
20%).
Conclusions:
Low
fluid
intake
appeared
to
contribute
to
dehydration.
Early
assessment
of
fluid
intake
and
hydration
status
is
critical
to
prevent
dehydration
in
older
hospitalised
patients.
It
is
recommended
that
health
care
staff
ensure
all
patients
are
able
to
open
the
provided
fluids.
Adequate
hydration
status
may
aid
in
the
patients
recovery,
reducing
their
length
of
stay
and
thus
the
cost
of
their
treatment.
